Efficacy of a 1‐week pantoprazole triple therapy in eradicating Helicobacter pylori in Asian patients

Abstract

The pantoprazole 1-week triple therapy with amoxycillin and clarithromycin is effective in H. pylori eradication. The treatment was well tolerated by patients. Metronidazole resistance was reported in a high percentage of strains isolated from patients. Clarithromycin resistance was, however, not detected in any of the strains.

Efficacy of 1‐week proton pump inhibitor triple therapy as first‐line Helicobacter pylori eradication regime in Asian patients: Is it still effective 10 years on?

“…In the Malaysian setting we have been monitoring H. pylori resistance to antibiotics periodically and our data showed that clarithromycin resistance rates have remained consistently low or absent over the years 5,30–32 . In another report from Malaysia, a similarly low clarithromycin resistance rate was reported 33 .…”

“…In another report from Malaysia, a similarly low clarithromycin resistance rate was reported 33 . Metronidazole resistance has been noted to be too high (over 70%) to be of any value in clinical use for H. pylori eradication in our setting 5,31 . Amoxycillin resistance is zero in the latest study from our center and remains a useful drug in the treatment of H. pylori 31…”

“…This has led to the use of several alternative regimes which include substituting clarithromycin with levofloxacin‐based triple therapy 15–18 and sequential therapies 19–21 as first‐line eradication therapies in areas of the world experiencing rising clarithromycin resistance. A previous study from our center showed that 1‐week pantoprazole triple therapy achieved high eradication rates of 90.7% per protocol and 83.0% ITT analysis, respectively 5 and the current study was carried out to determine if this regime still remained efficacious, 10 years after it was adopted as a first‐line eradication regime for H. pylori in this country.…”

Clarithromycin resistance and point mutations in the 23S rRNA gene in Helicobacter pylori isolates from Malaysia

“…The combination of PPI with amoxicillin and metronidazole, on the other hand, has consistently given lower eradication rates 4–6 . This is inherently a less potent treatment regimen and is further weighed down by the high resistance to metronidazole in many parts of the world, especially in Asia 8–10 . Both metronidazole and clarithromycin resistance have been shown to impact adversely on treatment success and are reported to cause a drop in eradication rates of over 50% 11 …”

Cost-effectiveness of and satisfaction with a Helicobacter pylori "test and treat" strategy compared with prompt endoscopy in young Asians with dyspepsia

“…Those tested positive were given eradication treatment consisting of pantoprazole 40 mg, amoxycillin 1 g and clarithromycin 500 mg twice a day each, for 1 week. This regime had previously been found to have an eradication success rate of 90.7% locally 18. Adults who were allergic to penicillin were given metronidazole instead.…”